Massage Therapy for Shoulder Pain
This article was originally published by PainScience.com.
Trigger points (TrPs), or muscle “knots,” are a common cause of stubborn & strange aches & pains, and yet they are under-diagnosed. The 14 Perfect Spots are trigger points that are common & yet fairly easy to self-treat with massage — the most satisfying & useful places to apply pressure to muscle. For tough cases, see the advanced trigger point therapy guide.
I avoided adding Spot 14 to this series for many years, because it’s a bit tricky to find. But precision is not required: although there is one specific spot that’s especially good, nearly anywhere under the ridge of bone on the shoulder blade is worthwhile, and often a surprising key to pain and stiffness everywhere else in the shoulder, especially all the way around on the other side, facing forward.
Spot 14 is the site of my best treatment success stories in a decade of professional massage. I tell the whole thing in another article. Here’s the short version: my wife’s uncle, tough as an old boot, was laid low by a toothache-like misery in the front of his shoulder, but after a just couple minutes of rubbing Spot 14 on the back of his shoulder, he was completely fixed… in less time than it takes me to make coffee. He was completely fixed… in less time than it takes me to make coffee.He spent that weekend swinging his arm around, chuckling, and saying, “Well, damn, ain’t that something!” He never had that problem again.
For most people, Spot 14 is a just pleasant surprise: a “secret” way to ease shoulder tension that almost no one has a clue about until they feel it, but after that it seems obvious. Learning about Spot 14 is a great way to get a reputation for magic hands.
How do you find Perfect Spot No. 14?
To qualify for “perfection,” a satisfying spot for massage should be both easy to get to and worthwhile. It is easy to get to the neighbourhood where Spot 14 lives. It’s just hard to find the exact address, which is the most worthwhile.
The neighbourhood is the triangular shoulder blade. Finding the infraspinatus muscle [Wikipedia] is basically as easy as touching the shoulder blade. That bone is mostly covered by the infraspinatus muscle, which is under (infra) the ridge (spine) of bone. The shoulder blade’s ridge of bone is roughly horizontal and spans the full width — it’s an easy bony feature to find. (There is a supra-spinatus muscle above it, but it’s much smaller and hidden under a thick layer of trapezius.) The infraspinatus is large, flat and mostly just below the skin (or a paper thin part of the trapezius).
This schematic shows how the fibres of the infraspinatus fill the space below the spine of the scapula, and converge on a point on the upper arm. When they contract, they spin the arm in its socket (arrow).
The entire muscle really is worth massaging, more satisfying than many other muscles, “good” for massage. But the top edge is “better” for massage. And “best”? Perfect even? Spot 14 tends to be quite a small, specific patch of muscle at one end of that strip, closest to the middle of the back: the upper, inner “corner” of the shoulder blade, just under the ridge. There really is one spot here that is particularly, profoundly sensitive in many people, but you can be right next it and no one is the wiser — it usually takes some fairly detailed fingertip and thumbtip exploration to “nail it.” On the bright side, I think it’s a noteworthy spot in easily 90% of the population, so the search probably won’t be in vain.
And if you miss it? Luckily, the rest of the muscle rarely disappoints. See below for “closely related spots.”
What does Perfect Spot No. 14 feel like?
More than any other perfect spot in this series, Spot 14 is obscure until you feel it. Spot 14 itself rarely aches or feels stiff, in my experience. Instead, people feel pain and tightness well lateral to Spot 14. Spot 14 lurks so far towards the inner edge of the shoulder blade that it almost doesn’t seem like a shoulder spot, but that’s it’s secret: rub it firmly, and almost anyone will feel the sensation spread laterally and penetrate through and around the rest of the shoulder.
Like most trigger points, Spot 14 will feel raw and burning if you are too hard on it, but it usually produces a sickly ache. Penetrating referral to the front of the shoulder can be surprisingly specific and isolated — almost as if the shoulder is being touched in two different places at one.
To learn more about the conditions massage can treat, check out our Massage Therapy blog.
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